Roentgenographic features of allergic bronchopulmonary aspergillosis

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ALLERGIC bronchopulmonary aspergillosis was described by Hinson, Moon, and Plummer1 in 1952. Since that time most of the case reports and investigations have come from England.2–6 The disease affects patients who are specifically hypersensitive to aspergillus antigens and is characterized by recurrent episodes of localized pulmonary infiltrations, wheezing, productive cough, and eosinophilia.

The following case report presents some of the pulmonary findings in this disease together with rather unusual roentgenographic features.

Report of a case

A 12-year-old Caucasian boy was examined at the Cleveland Clinic in August 1969 because of abnormal findings on a chest roentgenogram made at another institution. The patient had been under the care of an allergist for the last five years for the treatment of asthma. He had known allergies to dust and ragweed, with worsening of allergic symptoms during the springtime. His asthmatic attacks consisted of wheezing, dyspnea, and a cough, which was occasionally productive of thick sputum. He had not required hospitalization for control of the symptoms. In between the asthmatic attacks, the patient had frequent upper respiratory infection swith rhinitis and cough.

One year before examination at the Cleveland Clinic the patient had a chest roentgenogram that showed evidence of an infiltrate in the right upper lobe. The patient was asymptomatic at that time. Skin tests for histoplasmosis and tuberculosis at that time were negative. Therapy consisted of Tedral, potassium iodide, and desensitization.

A second chest roentgenogram obtained two weeks before examination by us showed evidence of multiple infiltrates in both lungs. . . .



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